Ankylosing spondylitis: symptoms and treatment

What is ankylosing spondylitis, its symptoms and treatment?

The maximum degree of thickening of the ligamentous apparatus is traced at the level of intervertebral discs.

When the whole vertebral column is affected, a strong bone skeleton is formed around it, limiting the mobility of the back.

A person with ankylosing spondylitis can not bend to the floor, make a complete turn of the trunk.

What is Bechterew's disease?

The international name for Bechterew's disease is ankylosing spondylitis. Causes of the disease are not established.

Pathogenetically, with nosology, activation of the genes of the HLA-B27 system is observed under the influence of provoking factors of the external environment. The triggering mechanism is autoimmune reactions.

Clinical studies of patients with ankylosing spondylitis revealed increased concentrations of IgA. The condition testifies to the role of the immunity system in the etiology of the disease.

European experimental studies in rats revealed a relationship between the activation of HLA-B27 expression and the onset of inflammatory bowel diseases, articular-ligamentous apparatus (colitis, spondylitis, jet arthritis). Convincing facts of triggering the histocompatibility system B27 under the influence of autoimmune factors were not found. The assumption is theoretical.

There is no convincing data from the theory of "mimicry". Her followers consider the combination of bacterial infection with HLA-B27 expression to be the main cause of Bekhterev's disease. The cause of ankylosing spondylitis remains unclarified.

Morphological changes in ankylosing spondylitis

With ankylosing spondylitis, morphological changes in the tissues can be traced:

• Symmetric inflammation of the sacroiliac joints;
• Growth of granulation tissue;
• The presence of chondrocytes, macrophages, fat and plasma cells in detritus;
• Erosion of the iliac cartilage followed by the formation of sacroiliitis (inflammatory changes in the joints of the sacrum);
• Fibrous-cartilaginous regeneration;
• Ossification of the ligamentous apparatus;
• Full obliteration of the sacroiliac joint.

The term "ossification" means the deposition of calcium salts in the joint-ligament apparatus of the spine. The process occurs at the site of growth of the granulation tissue, which is successively replaced by a bone analogue.

Calcification between adjacent vertebrae forms syndesmophytes (bone bridges). Over time, the process gradually spreads higher. The formation of constrictions between adjacent vertebrae is called "bamboo stick".

The syndrome is revealed on the roentgenogram, when carrying out a computer tomography.

Danger of Bechterew's disease is a consistent lesion of the fibrous ring of intervertebral discs with an increase in the probability of a hernia.

Arthritis of the epiphyseal joint is characterized by the formation of bone fusion. Calcification of tendons occurs in places of attachment of ligaments to the spine.

Breast ossification is accompanied by a breach of the chest excursion. Against this background, breathing becomes difficult, the heart rate decreases.

Violation of the excursion of the chest with damage to the intercostal ligaments is an irreversible condition, against which paresis of limbs develops.

The severe course of ankylosing spondylitis is accompanied by the involvement of humeral, hip joints with cartilage erosions, the growth of the synovial membrane, and the infiltration of tissue by lymphocytes.

In the fourth part of the patients, the iridocyclitis of the recurrent course is traced, followed by the formation of adhesions on the iris, deposition of precipitate on the posterior part of the cornea.

A prolonged course of ankylosing spondylitis is accompanied by aortic valve damage, thickening of the valves.

Part of the patients revealed fibrosis of the upper parts of the lungs, calcification of the walls of the colon, kidneys.

Symptoms of ankylosing spondylitis

The course of the disease is long. The initial stages are practically not detected. Small accumulations of calcium along the ligaments of the spinal column are not noticed by radiologists. Shadows of calcifications can be observed in elderly people, which complicates differential diagnosis.

Spondyloarthritis of Bechterew is formed secretly. Only after the appearance of constant prolonged pain the patient applies to a medical institution.

For pain syndrome with nosology, specificity is characteristic - it intensifies in the second half of the night. To reduce pain, the patient has to move and get up. A few weeks of soreness continues.

It is characterized by the morning stiffness of the lumbar spine.

With the ossification of the ligaments of the thoracic region there is an intense pain syndrome of the sternal-rib joints. In case of traumatic lesion of the lower thoracic region, dorsal kyphosis occurs.

Damage of costal-vertebral articulations is accompanied by a decrease in respiratory mobility of the chest. Dyspnea is seen in some patients. The inclusion of compensatory breathing from the side of the diaphragm leads to an increase in the ventral type of respiration.

Ankylosing spondylitis of the cervical spine: symptoms

Intensive rib pain is formed by calcification of the ligamentous apparatus of the cervical and thoracic spine. A common syndrome with spondylitis Ankylosing spondylitis - severe pain of the costal-chest joint. Formed with ossification of the ligaments of the thoracic spine.

The defeat of the neck leads to a decrease in mobility, compression of the vertebral artery, vertebrobasilar syndrome.

The consequence is a violation of the blood supply to the brain, short-term loss of consciousness.

With severe ankylosis of the cervico-thoracic spine, dorsal kyphosis is formed in patients.

Dizziness, headaches are often observed with ankylosing spondylitis of the cervical spine.

For childhood, Bekhterev's disease is not typical. If a nosology appears, it begins with joint arthritis. For young men, the spine is affected with a lack of clinical symptoms of sacroiliitis (inflammation of the sacral joints).

The initial stage of ankylosing spondylitis is revealed only on radiographs. The pictures show a narrowing of the articular cleft of the iliac articulations, an increase in the contours of the bones.

Sacroiliitis is the initial stage of nosology.

Symptoms are not expressed, but with gradual progression, mobility of the hip joints is difficult due to contractures (rough constrictions between the ligaments).

Peripheral spondylarthrosis: symptoms

The defeat of peripheral organs during calcification of ligaments can be traced in about 30% of patients. The most frequent complication is iridocyclitis, characterized by photophobia, eye pain, lacrimation.

With a slightly lower frequency (about 22%) there is a lesion of the cardiovascular system. Pathology is characterized by insufficiency of the aortic valve, aortitis, chronic heart failure. At part of patients, atrioventricular blockage of 2-3 degrees is traced.

Kidney damage occurs in 25% of patients with Bekhterev's disease. Complication leads to a pronounced inflammatory process. The consequence is amyloidosis with renal insufficiency.

Despite the classical onset of the disease with sakroileitis, part of the patients progress to cervical spine damage. At the expressed current of peripheral sakroileitis the following symptoms are observed:

• Violation of posture;
• Contraction of the hip joints;
• Atrophy of gluteus muscles;
• Strengthening of thoracic kyphosis;
• Smoothness of lumbar lordosis.

Decreased performance of the lumbar muscles is accompanied by pain sensations of the type of sciatica when flexing or lifting weights. Against the background of the pathology there is a decrease in working capacity.

The main symptoms of Bechterew's disease:

1. Tenderness of the hip joints;
2. Pain of the sacrococcygeal spine;
3. Strain of the musculature of the back;
4. Arcuate curvature of the spine;
5. Reduction of the volume of movements;
6. Sacroiliitis - inflammation of the sacral joints;
7. Puffiness of small joints of feet and hands;
8. Pain sensations of the heels of young people.

The above described clinical symptoms of Bechterew's disease make it possible to establish a diagnosis when examining a patient.

Bechterew's disease: treatment, drugs

The main task of treating Bechterew's disease is to remove inflammation, reduce pain, reduce the degree of deformation of the skeleton. With the purpose of preserving social and labor activity, therapeutic gymnastics is prescribed, aimed at the formation of posture, the normalization of breathing.

More effective drugs than non-steroidal anti-inflammatory drugs from Bekhterev's disease have not been created. The most common medicinal product of the group is indomethacin. The daily dose of the drug is 75 mg.

A slightly less pronounced effect in nosology is diclofenac, sulindac, naproxen. The choice of an effective drug for ankylosing spondylarthrosis should take into account side effects.

There are scientific works confirming the possibility of treating nosology with meloxicam in a daily dose of 2 mg.

Butadione (phenylbutazone) causes agranulocytosis, bronchospasm, anemia, gastropathy, decreased vision, but the daily dosage of 250-400 mg allows you to quickly eliminate the symptoms of Spondylitis Bechterew.

Treatment of peripheral forms of the disease is best performed with sulfasalazine at a daily dose of 1 gram four times a day. The drug is characterized by an analgesic effect, normalizes blood indices.

Treatment with cytostatics is carried out with ineffectiveness of the drugs described above. The drugs inhibit the activity of immunity, therefore, they are prescribed according to strict indications.

The daily dosage of methotrexate 1-2 mg for intramuscular or intravenous administration is sufficient to stop the symptoms of the disease with minimal effect on the secondary organs.

Second-line drugs for Bechterew's disease:

• Glucocorticoids;
• Immunosuppressive drugs;
• Penicillamine;
• Gold.

With a sharp deformation of the spine, symptoms of severe radicular infringement, 3-4 degrees of arthrosis of the hip joint, surgical treatment is performed. It is aimed at eliminating secondary symptoms of the disease.

A source: http://vnormu.ru/bolezn-behtereva-simptomy-lechenie.html

Bechterew's disease

Bechterew's disease (ankylosing spondylitis) is a systemic chronic inflammatory disease of the joints and spine that belongs to the group of seronegative polyarthritis.

This disease is mainly affected by men aged from fifteen to thirty years, and their number exceeds the number of sick women in five to ten times.

Although it is believed that in fact, Bekhterev's disease in women is not so rare, it is usually much lighter in its course than in men, which is why it is more difficult to diagnose

Causes of Bechterew's Disease

For certain, the cause of the development of Bekhterev's disease is unknown. However, it is known that this disease is most often developed in people with a certain hereditary predisposition and specific genetic characteristics.

After numerous observations and studies, it was proved that people with HLA-B27 gene carriers are more likely than others to suffer from Bechterew's disease.

However, this does not mean that people without the presence of this gene can not get Bechterew's disease - they can, but with a much smaller probability.

Until now, for scientists - rheumatologists it remains a mystery why some of the carriers of the HLA-B27 gene become ill, while others do not.

It was assumed that an important role in the development of this disease is played by viral infections, colds, various injuries and hidden infections.

Indeed, all of the above factors are capable of provoking the development of Bekhterev's disease, and aggravating its course.

But only recently, it became clear to modern scientists that Bekhterev's disease is in many respects a psychosomatic disease, the occurrence of which can be triggered by the peculiarities of the patient's nervous system and psyche, as well as prolonged or sufficient strong stress.

After carrying out a psychological analysis of patients with ankylosing spondylitis, a reasonable assumption was made that the disease generates in some cases a constantly restrained anger, and in others - the lack of psychological flexibility in the amount of disappointment in family relationships, work or life.

In such situations, a person is acutely aware of the inability to somehow change the situation, is burdened by sensation even if it was not done by anyone, that they would impose on him an unloved work, a companion of life and etc. On this emotional background, self-pity and constantly repressed anger at life circumstances

How Bekhterev's disease develops

With this disease, the inflammatory lesion initially affects the area of ​​joining the iliac bones and sacrum, and only then spreads first to the lumbar spine and up all vertebral pillar.

In case of further development, the inflammatory process can cover any joints of the human body - from the joints of the fingers to the hip joints.

However, most often with ankylosing spondylitis, ankle or knee joints, as well as Achilles tendons or spurs (tendon of the appendage region) become inflamed. Achilles tendons can swell sufficiently, becoming a spindle-like shape.

In the event that inflammation and pain in the field of Achilles tendons and heels occur before the age of thirty (no matter whether it is a man or a woman), one should be particularly alert.

If this inflammation was not preceded by a trauma and accompanied by a strong enough swelling of the tendon - in almost 90% of cases it indicates an inflammatory the nature of the disease and the patient must necessarily be checked for rheumatoid, psoriatic or reactive arthritis, as well as illness Bechterew.

Fortunately, inflammation and tendons in Bechterew's disease is very rarely as strong as in psoriatic or rheumatoid arthritis. In the overwhelming majority of cases, it can be easily suppressed with the help of medications.

Much worse is that with Bekhterev's disease, the so-called ossification of the ligaments develops both in the spine itself and in its intervertebral discs and joints.

There is a gradual process of "fusion" of vertebrae between each other, as a result of which the spinal cord loses its mobility and flexibility.

Without proper adequate treatment, a few years after the onset of the disease, the phase of complete immobility of the spine, when all of its vertebrae are fused, forming a single, bony, unbending structure. This condition is called "ankylosing"

Bechterew's disease symptoms

Bechterew's disease in the order of 10% of cases begins with cervical or lumbar radiculitis - the patient feels the so-called lumbago from the neck to the arm, or from the waist into one / both legs. Although much more often, ankylosing spondylitis begins gradually.

At the beginning, the symptoms are very similar to those of normal osteochondrosis. The patient is concerned about mild back pains that increase after rest or rest, as well as in cases of weather fluctuations.

But after warming up and even minor physical exercises, the uncomfortable sensations in the back are significantly reduced.

At the initial stage, back pain is eliminated with no problems with non-steroidal anti-inflammatory drugs, and in most cases they do not even cause the overwhelming majority of doctors to doubt that this is in its pure form osteochondrosis. Doubts begin much later, when the therapy of such "osteochondrosis" for months not only does not reduce pain, but even gradually their growth is observed.

In this situation, an experienced doctor should pay attention that the pain in the back is inflammatory: a little pain subsided during the day (often after noon) and on the contrary noticeably intensified at night after midnight (the peak of pain is 3 to 5 hours morning).

In addition to a fairly typical rhythm of pain, a possible diagnosis of Bekhterev's disease is indicated by the pronounced stiffness of the lower back in the morning, almost completely disappearing to dinner, as well as a fairly young age of the patient (osteochondrosis is usually diagnosed in the elderly, and Bekhterev's disease most often begins in twenty to twenty seven years).

Almost 50% of patients already early in the development of this disease, weight loss, an increase in body temperature, inflammation of the eyes ("sand in the eyes redness).

There is also the so-called "Scandinavian variant" of Bekhterev's disease, in which, as in the case of rheumatoid arthritis, small joints of the feet and brushes become inflamed.

However, the joints with Bechterew's disease are not subjected to such severe destruction as in rheumatoid arthritis and are quite amenable to therapy.

In 40% of cases, in patients with ankylosing spondylitis, joints do not become inflamed at all, and the inflammatory process affects only the spine.

In addition to all the above signs of this disease, perhaps the most characteristic symptom is the gradually increasing stiffness of the spine, as well as restriction on breathing of the mobility of the chest, which leads to various stagnant phenomena in the lungs and provokes the development of various complications: pneumonia, bronchitis, etc.

Ossification of the spine gradually leads to the fact that over time, the back almost completely or completely loses its original flexibility. The patient begins to move as if he had a stiff stick in place of the spine (this person can turn and bend only the whole body).

Appearance of the patient is quite typical.

In the initial stage of the course of the disease, the normal lumbar spine of the spine disappears, as a result of which the loin becomes straight and flat.

At a later stage, the thoracic spine freezes and a peculiar "pose of the petitioner" is formed. When walking, the patient's legs always remain slightly bent at the knees.

The signs that a patient with Bechterew's disease can be accurately distinguished from a person suffering from osteochondrosis:

"First sign." A person suffering from osteochondrosis, without lifting the feet from the floor and standing on straight legs, in most cases can bend deeply enough sideways - to the left or to the right.

In addition, a person suffering from Bekhterev's disease can with great difficulty make rotational movements (turning the body left / right) along the axis without detaching the legs from the floor

- The second sign.

At the initial stage of the development of Bekhterev's disease, the use of non-steroidal anti-inflammatory drugs in the necessary adequate dosage, almost always immediately (in the first hours after administration) gives, albeit a temporary, but powerful anesthetic Effect. And here at an osteochondrosis, reception of nonsteroidal anti-inflammatory preparations gives the necessary effect very rarely, and even if anesthesia is manifested, it is rarely complete and goes gradually

Complications caused by Bechterew's disease

The greatest danger is represented by aortic and cardiac lesions, which develop in 20% of patients and are manifested by irregularities in the work of the heart, chest pain, dyspnea. In 30% of patients developing amyloidosis - leading to renal failure renal failure.

Due to a decrease in the mobility of the chest, various lung diseases develop, and tuberculosis can develop.

To prevent the development of such complications, it is very important to identify, diagnose and begin the appropriate treatment of this disease at the earliest possible time.

At the slightest suspicion of Bekhterev's disease, the patient is obliged to go to the X-ray of the sacrum and spine in the shortest possible time. In addition, a clinical blood test and a blood test from the vein for accurate determination of inflammatory parameters

Treatment of Bechterew's disease

The main component of treatment for Bechterew's disease is non-steroidal anti-inflammatory drugs, which, with ankylosing spondylitis, are prescribed by continuous courses lasting from one to five years.

During periods of exacerbation of the disease, the patient is shown taking non-steroidal anti-inflammatory drugs in the maximum possible dosage, and after a recession exacerbation requires a return to the supportive regime: take 1/3 or 1/4 of the maximum allowable dose of the drug (indicated in the annotation to medicine). The maximum effect is produced by such non-steroidal anti-inflammatory drugs as ketoprofen, indomethacin, butadione, diclofenac, and anti-inflammatory drug Mawalis.

Thanks to these tools, the stiffness and pain in the joints and spine quite rapidly decrease, their mobility improves, and a positive dynamics is noted in the overall well-being of the patient.

As with rheumatoid arthritis, with Bechterew's disease, antimicrobial sulfasalazine is used as a basic therapy.

Despite the fact that the therapeutic effect of its administration has to wait a long time (about two to three months or more), it helps about 60-70% of patients.

Enzyme preparation vobenzym proved to be quite effective. After taking this drug, the enzymes that enter into it are absorbed very quickly in the intestines and then enter the bloodstream.

After that, the enzymes, moving along the blood vessels, penetrate into the inflammatory focus and begin to accumulate in it. Enzymes contained in vobenzima have anti-edematous, anti-inflammatory and immunoregulatory effects on the body.

Injections of corticosteroid hormones directly from the joint cavity, as well as compresses with dimexide, are administered directly to the inflamed joints for local effects.

With Bekhterev's disease, a tremendous effect produces cryotherapy of the back with liquid nitrogen.

In patients in 90% of cases, there is obvious rapid relief, pain decreases and stiffness of the spine decreases.

It should be noted that cryotherapy at home with the help of improvised drugs, almost does not help.

It is quite useful for Bekhterev's disease to massage your back, which has a beneficial effect on both the affected spine and the whole body in general.

In some cases, medical leeches help in this disease. Well-established protein diets have proved to be quite good with Bechterew's disease.

In addition, people suffering from this disease showed therapeutic gymnastics and sanatorium treatment.

A source: http://vlanamed.com/bolezn-bextereva/

Overview of Ankylosing spondylitis: causes, symptoms, diagnosis and treatment

articles:

Bechterew's disease is a long-term inflammatory disease of the joints (spine and limbs), which also occurs fusion of intervertebral ligaments, calcium salts are deposited in them, joints are blocked, and mobility of vertebrates is reduced segments. In the absence of treatment, disability occurs. The disease can last for years.

Other pathology names: ankylosing spondylitis, ankylosing spondylitis, ankylosing spondyloarteritis.

Spinal cord injury by Bechterew's disease

It is very important to diagnose the disease at the initial stage. Symptoms of the disease are quite common and nonspecific: pain, stiffness in movements.

Since Bekhterev's disease is "masked" for other diseases, doctors do not diagnose it in 72% of cases of treatment (and in women - in 94%).

At best, an X-ray will be assigned.

Because of the hereditary factor of development, it is considered that it is impossible to cure Bekhterev's disease; you can only stop the progression.

How the disease develops, what are its symptoms, the correct diagnosis and treatment methods - read on.

What happens with the disease?

Mechanism of development of the disease: inflammation of the capsule, places of attachment of ligaments and tendons, bone tissue.

The fibrin (a special protein) begins to be deposited and the inflammation passes to the cartilage. Further, fusion of connective tissue occurs, and then bone.

In 50% of patients peripheral joints are involved.

Five reasons for ailment

Five reasons for the occurrence of Bechterew's disease:

1. heredity,
2. immunological disorders,
3. rheumatic infection,
4. enterobacteria,
5. gonorrhea infection.

With Bechterew's disease, low mobility joints usually infest: sacroiliac (sacrolineum), arcuate, rib-vertebral, and large joints of the limbs.

There are 4 forms of Bechterew's disease.

(if the table is not completely visible - turn it to the right)

Symptoms and Diagnosis

Bekhterev's disease develops slowly, beginning with an almost imperceptible pain in the sacral department.

Pain symptom is clearly pronounced at night, more often it manifests itself in its second half. The nature of pain: pulling, dull, aching.

In the morning a person feels stiffness, then, as far as movement activity, it passes.

People with back pain appear more often to the neurologist, general practitioner, manual therapist.

Because of the similarity of the initial symptoms of the disease with other pathologies of the spine, often sound diagnoses: osteochondrosis, lumbulgia, protrusion or herniated discs.

They begin to be treated, but the real cause of the pain continues to progress.

In the presence of characteristic symptoms, you should contact a rheumatologist. A competent specialist will conduct a survey according to the following criteria:

• age 15-45 years;
• night pains;
• stiffness in the morning;
• pain increases in rest, decreases with movement;
• gradual onset of discomfort;
• presence of the disease in relatives;
• psoriasis;
• inflammatory bowel disease;
• urethritis;
• diarrhea;
• pain in the buttocks (alternately, in the left and right);
• hypercalcemia and high ESR in blood analysis;
• thoracic kyphosis of the spine.

To diagnose Bechterew's disease, you need: MRI (reveals the onset of the disease) and radiography.

Of particular importance is the analysis of antigen detection of the incompatibility complex HLA B27.

Although its clinical role has not yet been deciphered, it is found in 90% of people with ankylosing spondylitis.

Complications

Bekhterev's disease, with untimely treatment, leads to complications:

• deformation of the spine;
• limitation (loss) of motor activity;
• eye diseases;
• diseases of the heart, vessels;
• kidney diseases;
• diseases of the respiratory system.

In neglected cases, the ability to move is lost and disability occurs.

Methods of treatment

Treatment of Bechterew's disease is aimed at eliminating pain, eliminating inflammation, stopping the process of proliferation of connective tissue and deformation of bones and cartilage.

Medicines

Regardless of the degree of development of the disease, when diagnosing Bekhterev's disease, the main symptoms should be eliminated: inflammation and pain.

For this purpose, anti-inflammatory drugs (NSAIDs) are prescribed: diclofenac, indomethacin, as well as rheopyrin, butadione and others. Possible application of sulfasalazine: it has an anti-inflammatory and bactericidal effect.

It is very effective to use selective NSAIDs. With Bechterew's disease, they can be used for a long time without negative consequences. These drugs include arkoksia.

Physiotherapy

Physiotherapy for Bechterew's disease is used for:

• eliminate pain,
• removal of inflammation and swelling,
• enhance metabolism in connective tissue,
• decrease in the immune response,
• relaxation of muscles,
• elimination of contractures (limitations of joint mobility).

It is a medicinal phonophoresis and electrophoresis. They have anti-inflammatory and analgesic action, resolve (defibrate) the connective tissue, eliminating adhesions and scars.

Fiber modeling methods

This is paraffinotherapy, ozokeritotherapy, various baths (radon, hydrogen sulphide, etc.). They increase tissue metabolism, cell regeneration, resorption of infiltrates, reduce muscle spasm and pain.

Correction methods for posture

This stretching, stretching, massage, relaxation. This effect increases the mobility of vertebral segments, improves microcirculation, relaxes muscles. In massage, rubbing, stroking, kneading, and vibration are used.

The methods of exposure, their duration and the number of courses are set individually by the doctor.

Exercise therapy

Therapeutic exercises with Bekhterev's disease are strictly dose-related exercises according to the indications and under the supervision of the doctor.

It normalizes the changed functions of joints, strengthens ligaments and muscles, restores nervous conduction, blood and lymph circulation.

Under the influence of prolonged and persistent training, the symptoms of the disease disappear, and the functions of the damaged joints can be restored.

Prevention

To prevent the development of Bechterew's disease, physical activity is necessary.Very well affects the joints swimming, especially in combination with exercise therapy.

If possible, it is obligatory (at least once a year) to go to sanatorium treatment in mud resorts, resorts with sulfide and radon waters.

To avoid deformation of the spine - sleep a moderately hard mattress and with a flat cushion (or without it).

A source: http://SustavZdorov.ru/raznoe/bolezn-bekhtereva-259.html

Bechterew's disease: what is it and how to treat it properly

Ankylosing spondylitis, received the second name by the name of the neurologist who first described the disease, is chronic inflammation of the intervertebral joints, leading to their fusion (ankylosis) and immobility. The disease can seriously reduce the quality of life of the patient, so it is so important to know about Bekhterev's disease what it is and how to treat it for men and women of different ages.

Bechterew's disease - what is it?

Patients diagnosed with this disease are asked:what is Bekhterev's disease?Note that this pathology develops in men under the age of 30 years 9 times more often than women. Yes, and it is more difficult for men. The prevalence of the disease in different countries is from,% to 2%, in Russia it is affected by it,% of the population.

The mechanics of Bechterew's disease consists in the fact that the inflammatory process affects the joints of the spine, large (and in some cases and small) joints of the limbs, joints of the sacrum with the pelvis of the pelvis, which leads to complete immobility patient. In addition to the osteoarticular system, pathology develops in the internal organs - the kidneys, the heart, the iris of the eyes. The combinations of these lesions can be different.

Important to know: Bekhterev's disease has a chronic progressive course.

Symptoms of Bechterew's Disease

In the initial period, inflammation of the intervertebral ligaments and sacroiliac joint is characteristic, which is manifested by pain in the lower back. Although in some patients, inflammation begins with the joints of the limbs.

The most characteristic signs of ankylosing spondylitis:

• pain in the lumbosacral region with irradiation in the thigh and lower leg, constrained movements; but their patients are often (and sometimes doctors) regarded as a manifestation of radiculitis, osteochondrosis;
• rest and lack of movement strengthen stiffness and pain, so they are most noticeable in the pre-dawn hours, and decrease throughout the day; this "morning" syndrome is specific for this disease;
• the spread of pain and stiffness from the bottom up the spinal column: with the defeat of the thoracic region, the difficulty of deep breathing and the intensification of pain will even cause coughing, sneezing;
• involvement in the process of all new joints - from the hip to the fingers;
• prolonged pain in the heels;
• accelerated ESR for blood analysis (up to 40 mm / h and above);
• without treatment, the physiological curves of the vertebral column disappear, the posture is disturbed: the patient acquires the "proud" posture (unnatural straightened waist and inability to incline) or "petitioner" (back stoop, slightly bent legs, head tilt anteriorly, arms bent in the elbows);
• limitation of mobility as the disease progresses: they become difficult and become painful movements head, any torso of the trunk; without treatment, full immobility develops, when the patient is chained to bed.

The disease is manifested not only by problems from the musculoskeletal system, but also by symptoms of lesions of other organs: the iris of the eyes is frequently affected (iridocyclitis develops), the heart (pericarditis), breathing is disturbed due to deformity of the thoracic cells,

For the diagnosis, a radiographic examination and a blood test for the antigen HLA B27 are used. But in the early stages of a more sensitive method - MRI.

Causes of the disease

Bechterew's diseaseConsider a systemic autoimmune disease, the causes of which are not fully understood.

Scientific studies have shown that its development requires antigen HLA B27. It is found in 90% of patients with ankylosing spondylitis.

The detection of this antigen does not mean the mandatory development of the disease, but only indicates a hereditary predisposition to it.

One of the theories of the onset of the inflammatory process is the influence of certain infections and the subsequent malfunction in the immune system.

Antigen HLA B27 gives similarities to some types of pathogens of infections with the articular tissue of the patient's body.

As a result of immune disorders in the body, antibodies are produced not only to pathogens infection, and to their own articular tissues, recognizing them as alien, that is, the body itself destroys.

Studies of recent years in animals have shown the mandatory participation in the development of ankylosing spondylitis 3 components: antigen HLA B27, causative agent of infection and T-lymphocytes (immune cells involved in the control of pathogen). When the animal is kept in sterile conditions (that is, the infection is excluded) or the removal of animal thymus (a special gland for the development and maturation of T-lymphocytes), inflammation of the joints evolved.

To start such an autoimmune process can:

1. acute infectious disease, including colds and sexually transmitted diseases;
2. chronic infections (most often they are infections of the urinary system and intestines);
3. injury;
4. often occurring stresses.

An important role in the development of the initial lesion of the sacroiliac joint is played by tumor necrosis factor (TNF-a).

This is a special protein that shows high activity in addition to the tumor process in inflammatory and immune reactions.

It is in this joint articulation that there is a large number of TNF-a.

Dangerous complications of Bechterew's disease

Bechterew's diseasewill provoke the emergence of a number of dangerous complications:

• every fifth patient develops a lesion of the cardiovascular system, manifested by painful sensations for sternum, dyspnea, violation of the rhythm of cardiac activity; the risk of developing hypertension, heart attack, and stroke;
• every 3rd patient develops kidney amyloidosis with subsequent renal failure (dystrophic lesion and renal transformation due to the violation of protein metabolism with deposition in them of a specific protein-carbohydrate complex amyloid);
• Amyloidosis can affect other organs (liver, heart, etc.) with the development of functional insufficiency of these organs; range manifestations in these cases is very wide: weight loss, fatigue, dyspnea, edema, numbness of upper and lower extremities, increase liver and others;
• low mobility and deformation of the chest contribute to the development of pneumonia (pneumonia) and tuberculosis;
• a pronounced decrease in the flexibility of the spine due to the fusion of bones and joints develops in 40% of cases and leads to the fixation of the posture in one position (the pose of the "petitioner");
• the defeat of joints (especially knee, hip) is manifested by inactivity and pronounced soreness in them;
• inflammation of the iris of the eye (uveitis or iritis), the signs of which are redness and soreness in the eye, photophobia (excessive sensitivity to light), visual impairment (vagueness and turbidity), can lead to complete or partial loss of vision (more often is affected 1 eye);
• osteoporosis of bones (a progressive disease characterized by a breakdown in the structure of bone tissue and a decrease in its density) leads to increased bone density fragility and increased risk of vertebral fractures; while prolonged immobility in the gypsum further aggravates the severity of the main ailment;
• a rarely developing, but dangerous complication is "horse tail syndrome" - compression of the bundle of nerve roots of the lower parts of the dorsal brain; the syndrome is manifested by incontinence of urine or feces, weakness of the legs, up to the disturbance of walking and paralysis, numbness and pain in the lower back and buttocks.

Methods of treatmentSevere form of ankylosing spondylitis without treatment leads to a decrease or loss of ability to work.

Techniques and medicines for a complete cure ofBechterew's diseaseno, but using the right and regular treatment courses can slow down the progression of the disease, improve the patient's quality of life.

Integratedtreatmentincludes 3 stages:

• in the hospital during the period of exacerbation;
• sanatorium-resort course;
• outpatient stage.

As a drug therapy non-steroidal anti-inflammatory drugs and corticosteroids are used for anti-inflammatory process and immunosuppressants for immunocorrection (suppression of aggressive immune reaction).

A source: http://doctor-hill.net/bolezni-oda/bolezn-bekhtereva-chto-eto-i-kak-pravilno-lechit.html